Persistent Achy Groin Pain when Playing Hurling & Football

This week, I will talk about a Groin in a young adult that has been persistent for the past month with no sign of easing. The adult in question recently returned to playing hurling after a year break, and has bgun to expereince achy groin pain immediately when running and after 20 minutes when sitting down. He has had no traumatic injury or no history of lower back or Hip Pain. His Symptoms and aggravating factors are listed below;

Symptoms & Aggravating Factors

• Achy Pain high up in the Groin area, away from the Pubic region.

• No Pain in buttock, no Lower back pain, no Pins & Needles, no issues with hernia or abdominal related pain.

• Groin Pain when lying on his spine with knees straight

• Slight Pain with walking, when hip is pulled backwards into extension

• No Clicking or catching of Hip

• Aggravated with Running and playing Hurling

• Groin Pain appears after 20 minutes of sitting

• Pain when bringing the hip towards the chest with testing.

• Left Groin Pain when he twists or turns Left.

• Pain when knees are squeezed together and when squating

What is the Injury?

The injury is classified as adductor related groin pain, due to pain on knees squeeze test and pain on a functional twisting movement to painful side. I can arrive at this diagnosis due to no pain hip flexor resistence and painfree Hip Internal & External rotation plus no clicking, thus discounting Hip Flexor and HIp Labrum irritation involvement.

Treatment & Management

Simply massaging the the groins and glutes muscles will not work! It's a irritated on movement overload of the Adductor Groin tendons, so hence I need to commence isometric squeeze exercises at a painfree level which in this case is the patient lying on their spine and squeezing a pillow between knees with approx 70% of their strength. This techniqu, when used with correct diagnosis, can help relieve pain on left turning movement, hence I used it as an isometric exercise before and after running, helping to reduce groin pain significantly. The excises were progressed overtime with the following principles adhered to;

• Avoid Stretching adductors & Hip Flexors - irritates pain

• Reduce Running durations

• Avoid Deep squats and side lunges

• Avoid side-stepping & Cutting Movements

Please note that this treatment plan was used only when I correctly daignosed the pain and she not be used in the event where groin pain has not been correctly diagnosed!

Tomás Ryan is a Registered Physical Therapist (MIAPT) with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672 Email your queries to: tomaspryan@gmail.com